Risk analysis for the design of a safe artificial pancreas control system

  • Konstanze KölleEmail author
  • Anders Lyngvi Fougner
  • Mary Ann Lundteigen
  • Sven Magnus Carlsen
  • Reinold Ellingsen
  • Øyvind Stavdahl
Original Paper


Closed-loop glucose control has the potential to improve the glycemic control in patients with diabetes mellitus type 1. Such an artificial pancreas (AP) should keep the user safe despite all disturbances and faults. The objective of this paper is to analyze those perturbations according to their effects on the glycemic status, and thereby supporting an informed design process of the control system. As suggested by the international standard ISO 14971 for risk management of medical devices, the well proven failure modes and effects analysis (FMEA) was chosen as instrument. An FMEA scheme was modified for this purpose and applied to a single-hormone system with subcutaneous and intraperitoneal routes for glucose sensing and insulin administration. Faults that imply urgent danger and thus require fast detection and diagnosis were identified and distinguished from disturbances that can be sufficiently addressed by basic control functions, e.g. by adaptive control algorithms. Requirements and testing criteria for basic control functions as well as fault detection and diagnosis functions can be derived from the provided overview.


Artificial pancreas Type 1 diabetes Fault detection Risk analysis Closed-loop systems Glucose control 



The study was financed by The Liaison Committee for Education, Research and Innovation in Central Norway (project no. 46075403), and partly by the Research Council of Norway (project no. 248872) and the Centre for Digital Life Norway. The authors would like to thank Sverre C. Christiansen for invaluable input.

Compliance with ethical standards

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Author disclosure statement

An abstract and a poster with preliminary results from this paper were presented at the ATTD conference in Milano, February 2016. All authors expect M. A. Lundteigen are members of the Artificial Pancreas Trondheim (APT) research group ( which focuses on the double intraperitoneal approach for an artificial pancreas. R. Ellingsen is a shareholder and board member of GlucoSet, a company in the glucose monitoring field.

Conflict of interest

The authors declare that they have no conflict of interest.


Adverse event

Any untoward medical occurrence, unintended disease or injury, or untoward clinical signs (...) in subjects, users or other persons, whether or not related to the investigational medical device [110]

Artificial pancreas

Closed-loop control of blood glucose in diabetes, is a system combining a glucose sensor, a control algorithm, and an insulin infusion device [111]


An unknown (or uncontrolled) input acting on a system [112]


Discrepancy between a computed, observed or measured value or condition, and the true, specified or theoretically correct value or condition [113]

Failure mode

Manner in which a failure occurs [113] (Fault modes rather than failure modes are actually analyzed in an FMEA, but the term failure modes and effects analysis is the common name of this methodology [7].)


The termination of the ability of an item to perform a required function [113]

Fault detection

Event by which the presence of a fault becomes apparent [113]

Fault diagnosis

Action to identify and characterize the fault [113]

Fault identification

Determination of the size and time-variant behaviour of a fault. Follows fault isolation [112]

Fault isolation

Determination of the kind, location and time of detection of a fault. Follows fault detection [112]

Fault tolerance

Ability of an item to perform a required function in the presence of certain given sub-item faults [113]


Inability to perform as required, due to an internal state [113]


Physical injury or damage to persons, property, and livestock [113]


Potential source of harm [113]

Hazardous event

Event that can cause harm [113]

Hazardous situation

Circumstance in which persons, property and livestock or the environment are exposed to at least one hazard [113]

Intended use

Use of a product, process or service in accordance with the information for use provided by the supplier [113]


An input acting on a system, which results in a temporary departure from the current state [112]

Random hardware failure

Failure, occurring at a random time, which results from one or more of the possible degradation mechanisms in the hardware [114]

Reasonably foreseeable misuse

Use of a product, process or service in a way not intended by the supplier, but which may result from readily predictable human behaviour [113]


Ability to perform as required, without failure, for a given time interval, under given conditions [113]


A fault indicator, based on a deviation between measurements and model-equation-based computations. [112]

Risk analysis

Systematic use of available information to identify hazards and to estimate the risk [113]


Combination of the probability of occurrence of harm and the severity of that harm [113]


Freedom from unacceptable risk to the outside from the functional and physical units considered [113]

Systematic failure

Failure that consistently occurs under particular conditions of handling, storage or use [113]


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Copyright information

© IUPESM and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Engineering CyberneticsNorwegian University of Science and Technology (NTNU)TrondheimNorway
  2. 2.Department of EndocrinologySt. Olavs University HospitalTrondheimNorway
  3. 3.Department of Mechanical and Industrial EngineeringNorwegian University of Science and Technology (NTNU)TrondheimNorway
  4. 4.Department of Clinical and Molecular MedicineNorwegian University of Science and Technology (NTNU)TrondheimNorway
  5. 5.Department of Electronic SystemsNorwegian University of Science and Technology (NTNU)TrondheimNorway

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